Association between treatment-resistant kidney-allograft rejection and post-transplant appearance of antibodies to donor B-lymphocyte alloantigens.

In 18 kidney-allograft recipients the post-transplant appearance of antibodies to B-lymphocyte (DRw) alloantigens of the kidney donor was significantly associated with the rejection of the graft within 1 month of transplantation or the poor recovery of graft function, despite treatment for rejection. None of the 10 recipients whose grafts were accepted or whose renal function recovered well after treatment for rejection made antibodies to donor B-lymphocyte antigens after transplantation. DRw antigens are thus targets for the host's immune response to a graft and may be responsible for kidney rejection in patients who do not respond to rejection therapy.